Do I just have hanging columella now? (Photo)

Question

I had a rhinoplasty 4.5 years ago and was overall happy with the results but my nostrils now look huge and the columella looks droopy. I know I still have some asymmetry but I'm not worried about that as much as fixing the profile view. Do I have just a hanging collumella or something more?

Luis M. Rios Jr., MD · Answer

It does appear that you do have columellar show. In other words you can see inside your nostrils.
The photos you provided are very good. It appears that the columellar show may be due to two conditions. You have a little bit of a hanging columella, but you also have retraction of the ala (nostrils) from the resection of your lower lateral tip cartilages. I think both of these things are adding to what you are seeing.
I am going to use some technical terms now, so that you can do some research about the techniques to see what appeals to you. If you approach this surgically, I would begin in a step wise fashion. I would consider starting with a slight (2-3 mm) resection of the caudal septum along with some nasal lining resection. This will lift your columella and close the gap. If this is not enough I would then address the retracted alar rims. There are two techniques to consider. One is to place small alar rim grafts to push the nostrils down. The cartilage grafts (from the ear or septum) could be placed in small pockets using small incisions on the inside of the rim of your nostrils. The incisions would be hidden. Another technique is to use a V-Y flap of the inner nasal lining of the nostril to help lower the nostril rim.
So again, the surgical approaches would be either to lift the columella or lower the nostril rim. Both of these approaches would help close the nostril gap and reduce the columellar show.
I know I have used technical terms, but again you can use these terms to do your research.
The point of all of this, is that you should find an experienced rhinoplasty surgeon to help you. You should find a surgeon who specializes in rhinoplasty revisions. 
Good Luck

Marcelo Antunes, MD, FACS · Answer

Thank you for your question.
An excessive show of nostrils can be due to a hanging columella, a retraction of the nasal or a combination of both. In your situation, seems to be related to the hanging columella. This is typically a straightforward thing to correct.
I recommend you see a rhinoplasty surgeon in your area to discuss the problem and create a treatment plan. Good luck

Vasdev Rai, MD · Answer

You need a touchup. You have hanging columella. Overall you have good outcome. Nothing else needs to be done.

Fred J. Bressler, MD, FACS · Answer

Thanks for your post and photos. I share your concerns about the profile and columellar show. Your nostril from the side views are too prominent, which suggests a hanging columellar deformity with possible alar retraction. From your frontal view, your nose may still be too long. This is often related to the nasal septum length. Fortunately, you may be able to correct these concerns with a revision rhinoplasty. A consultation with your primary surgeon or other rhinoplasty specialist may offer you recommendations to further enhance your overall result. Please contact my office if you wish additional information. Best Wishes.

Richard W. Fleming, MD (retired) · Answer

You do have a hanging columella which can be lifted and some minimal retraction of the nostril rim. Both of these problems can be corrected with minimally invasive revisions.

Do I just have hanging columella now? (Photo)

Answers (6)

Answer: Hanging Columella? Yes

Answer: Hanging Columella? Yes

Answer: Do I Have a Hanging Columella

Answer: Do I Have a Hanging Columella

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Do I just have hanging columella now? (Photo)

Answers (6)

Answer: Hanging Columella? Yes

Answer: Hanging Columella? Yes

Answer: Do I Have a Hanging Columella

Answer: Do I Have a Hanging Columella

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Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.